Organization
FAMILY HEALTH NETWORK OF CENTRAL NEW YORK, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY OSBORNE (CEO)
(607) 753-3797
Entity
Organization
Contact information
Practice address
85 SOUTH WEST STREET, HOMER, NY 13077-0000
(607) 753-3797
(607) 753-6677
Mailing address
85 S WEST ST, HOMER, NY 13077-1542
(607) 753-3797
(607) 753-6677
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
NY
207Q00000X
Family Medicine Physician
—
NY
207VG0400X
Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
NY
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363A00000X
Physician Assistant
—
NY
363L00000X
Nurse Practitioner
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00474144
—
NY
Enumeration date
12/19/2006
Last updated
10/09/2023
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